三腔二囊管辅助急诊内镜下治疗食管胃底静脉曲张破裂出血的临床研究

Using Sengstaken-Blakemore tube as assist treatment of escophageal and gastric variceal bleeding under emergency endoscopy

目的探讨三腔二囊管在辅助急诊内镜下组织胶注射术联合硬化剂注射、静脉曲张套扎治疗食管胃底静脉曲张破裂出血的作用。方法按就诊先后顺序选择60例患者,并采用单盲随机法分为研究组及对照组各30例,研究组运用三腔二囊管辅助急诊内镜下组织胶注射术联合硬化剂注射、静脉曲张套扎治疗食管胃底静脉曲张破裂出血,对照组运用常规急诊内镜下组织胶注射术联合硬化剂注射、静脉曲张套扎治疗食管胃底静脉曲张破裂出血,对两组疗效进行比较。结果研究组30例患者治疗均获成功,止血效率为100.00%(30/30),明显高于对照组的76.67%(23/30),差异有统计学意义(P<0.05)。研究组食管胃底静脉曲张治疗后消失率为63.33%(19/30),明显高于对照组的14.28%(4/28),差异有统计学意义(P<0.05)。胸痛和发热、总住院天数和总医疗费用研究组明显低于对照组(P<0.05)。结论采用三腔二囊管辅助急诊内镜下组织胶注射术联合硬化剂注射、静脉曲张套扎治疗食管胃底静脉曲张破裂出血可提高治疗效率,减少患者并发症的发生及经济负担。

Objective To evaluate the effect of Sengstaken-Blakemore tube in assisting cyanoacrylate injection combined with sclerotherapy and variceal ligation under emergency endoscopy in treating escophageal and gastric variceal bleeding. Methods 60 patients were randomly selected, and were evenly divided into 2 groups single blindly. Endoscopic cyanoacrylate injection, sclerotherapy and variceal ligation were performed in control group, and additional Sengstaken-Blakemore tube were used in experimental group. Results All the 30 patients in study group got effective hemostasis （30 of 30, 100.00 %）, whereas only 23 patients in control groups stopped bleeding （23 of 30, 76.67 %） （P〈0.05）. escophageal and gastric variceal were cured 19 patients in the experimental group （19 of 30, 63.33 %） , and only 4 were cured in the control group （4 of 28, 14.28 %） （P〈0.05）. Meanwhile, occurence of fever, chest pain, hospital days and hospitalization costs of experimental group was significantly lower than that in control group （P〈0.05）. Conclusions Treating the escophageal and gastric variceal bleeding, using endoscopic cyanoacrylate injection, sclerotherapy; and variceal ligation under emergency endoscopy combined with Sengstaken-Blakemore tube could significantly increase the therapeutic efficiency as well as reduce complications and therapy cost.